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肩胛运动对急性脑卒中患者躯干控制的影响:一项双盲随机对照研究。

Effects of scapular exercises on trunk control ın patients with acute stroke: a double-blind randomized controlled study.

作者信息

Oz Rabia, Duray Mehmet, Cetıslı Korkmaz Nilufer

机构信息

School of Physical Therapy and Rehabilitation, Pamukkale University, Denizli, Turkey.

Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Süleyman Demirel University, Isparta, Turkey.

出版信息

Somatosens Mot Res. 2024 Dec;41(4):272-280. doi: 10.1080/08990220.2023.2283503. Epub 2023 Dec 11.

Abstract

PURPOSE/AIM: The ability to perform routine tasks during reaching and activities of daily living (ADLs) is impaired as a result of deterioration in the postural adjustments after stroke. Trunk stability is needed to maintain balance, correct scapular position and posture while moving the upper extremity. The objective was to examine the effect of scapular exercises on the scapular stability, trunk control and ADLs.

MATERIALS AND METHODS

Patients (50-85 years) with acute hemiparetic stroke were participated in this double blind randomized controlled study. The patients in both group were treated with the exercise program according to the Bobath concept and isometric scapular exercises were applied to the study group in addition to these exercises. The participants in both groups were taken into the physiotherapy program for 5 days and each program were taken 30 min. Patient assessment included Lateral scapular slide test (LSST), Trunk Impairment Scale (TIS), Trunk Control Test (TCT), Modified Barthel Index (MBI) and Reaching Performance Test (RPT).

RESULTS

Significant increases were observed distance in protraction, between protraction - retraction at 90° of shoulder abduction and flexion and retraction in 90° of shoulder abduction within both groups. Only the study group produced improvement in protraction of 90° of shoulder flexion ( < 0.05). While both groups achieved a significant improvement in TIS, MBI, RPT scores, TCT scores increased significantly only in study group ( < 0.05).

CONCLUSIONS

The adding isometric scapular exercises to the rehabilitation program significantly increased the effectivity of neurorehabilitation on increasing trunk control, independence during ADLs, reaching performance and reducing trunk impairment.

摘要

目的/目标:中风后姿势调整能力下降,导致在伸手够物及日常生活活动(ADL)中执行常规任务的能力受损。在移动上肢时,需要躯干稳定性来维持平衡、纠正肩胛骨位置和姿势。本研究的目的是探讨肩胛骨运动对肩胛骨稳定性、躯干控制及日常生活活动能力的影响。

材料与方法

50 - 85岁急性偏瘫性中风患者参与了这项双盲随机对照研究。两组患者均按照Bobath理念进行运动训练,研究组在此基础上还进行了等长肩胛骨运动训练。两组参与者均接受为期5天的物理治疗,每次治疗30分钟。患者评估包括肩胛骨外侧滑动试验(LSST)、躯干功能障碍量表(TIS)、躯干控制测试(TCT)、改良Barthel指数(MBI)和伸手够物能力测试(RPT)。

结果

两组患者在肩胛骨前伸距离、肩关节外展和屈曲90°时前伸 - 后缩距离以及肩关节外展90°时后缩距离均显著增加。只有研究组在肩关节屈曲90°时的前伸方面有改善(P < 0.05)。两组患者的TIS、MBI、RPT评分均显著提高,而TCT评分仅在研究组显著提高(P < 0.05)。

结论

在康复计划中增加等长肩胛骨运动训练,可显著提高神经康复在增强躯干控制、提高日常生活活动独立性、改善伸手够物能力及减轻躯干功能障碍方面的效果。

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